In the article, titled FHIR: Technology and Governance, Rob discusses why the new standard is so popular in health IT circles and why it is a key advancement in the industry's quest for real interoperability, including the use of mobile devices and the inclusion of patient-generated health data in EHR systems. However, the intent of Rob's post is to highlight the need for governance in order for FHIR to avoid the same adoption issues that have plagued Direct Project.

Interoperability, the electronic exchange of patient information between IT systems, continues to elude many in the health care industry. A draft standard -- called Fast Healthcare Interoperability Resources, or FHIR -- could change that by unlocking data held in electronic health record silos.

A modern healthcare environment demands that an interface engine do more than just connect one point to another.

The role of the interface engine must meet the requirements of a new generation of productive, connected, and efficient healthcare environments. Explored are the five major areas where the role of an interface engine is applicable within a modern healthcare environment.

If you’ve been putting your head in the sand before – you can now see that both Congress and the Administration have put out formative proposals with a common thread: fee-for-service is a sinking ship. It’s time to get off soon, folks. Are you ready?

Experts tell committee that business models, not technology, are the main obstacle to better sharing across systems.

Chad Johnson's insight:

At a March 17 hearing of the Senate Health, Education, Labor and Pensions Committee, lawmakers explored the progress on EHR adoption. Committee Chairman Sen. Lamar Alexander (R-Tenn.) said the Obama administration "seems to have complicated the process by rushing ahead with penalties for those who don't adopt EHR systems," even though systems that are certified by Office of the National Coordinator for Health IT can fail to offer the necessary functionality or conform to program requirements.

As they move to exchange patient information with hospitals and other health care partners, doctors are suffering sticker shock: The vendors of the health care software want thousands of dollars to unlock the data so they can be shared. It may take an act of Congress to provide relief. The fees are thwarting the goals of the $30 billion federal push...

The Connectathon attracts more than 500 health IT professionals each year who are there to represent various health IT vendors who often compete for customers outside of the event. In this collaborative environment, each vendor attempts to pass tests utilizing various IHE profiles that users of their product are likely to utilize in real world data exchange scenarios.

"Chilmark Research has outlined adoption in the provider market, as well as provided a framework for the diverse set of technologies and product features, new and old, that comprise the toolkit for patient engagement. We interviewed over a dozen market-leading vendors, numerous delivery systems and healthcare executives and other industry stakeholders to cut away the hype and find out exactly where the market is today."

I have told my staff that I believe in five years it won’t be the IT department, it would be the cloud services department. That is our job will be to empower our users with services. And we might provide some of them, but probably, we’ll procure them. That is sort of the nature. Does anyone really want to run an email server anymore? Not really, right?

Nobody is explicitly opposed to interoperability in healthcare IT. That would be like opposing the eradication of poverty or hunger or child slavery. People of good will just can't argue against it. The potential benefits are too clear.

The Meaningful Use - Stage 3 proposed rule has been released, with official publication due on March 30. Llikewise, the 2015 edition of EHR certification criteria and related rules. Check out the CMS presser and ONC fact sheet. Key to...

Everyone in the industry is extremely excited about the technology of FHIR – as well they should be. But, have we forgotten about the other half of the picture?

Healthcare has unique, complex issues with regards to protecting PHI that no other industry encounters, not even banking. How do we make sure that we don’t end up in a similar place as Direct Project?

Chad Johnson's insight:

I’m not asking the industry to pump the brakes on FHIR progression and get bogged down in the same committee-driven bureaucracy that has weighed down Direct(e.g., DirectTrust). It would be wise, however, to involve IHE or some other governing body, to streamline, safeguard, and motivate provider organizations to utilize FHIR. Using these three principles may provide a better blend to achieve FHIR- inspired health interoperability.

Rep. Mike Burgess (R-TX) is floating electronic health record interoperability language he hopes to insert into the Energy and Commerce Committee's 21st Century Cures draft bill and has asked for stakeholder feedback by Friday (March 13) on data-sharing criteria, including who should be cleared to see patient data and who should establish interoperability standards.

But there are signs of progress, and a path forward, as outlined by a HHS-commissioned report on health data infrastructure and a new HHS strategic plan for interoperability. Building on these visions, and under the leadership of HL7, a leading health IT standards body, a number of health IT vendors, hospitals, and medical organizations have come together to develop a common specification (Fast Healthcare Interoperability Resource, or FHIR) to enable expanded sharing of electronic health records. This will make it easier for software (such as the electronic health record system at a different hospital, or your smartphone health app) to access your data privately and securely.

If the Federal government did not have some kind of standards for EHR systems, then doctors might choose to install some Microsoft Word macros and claim that they should be counted as EHR systems, and qualify for funding. (I wish this was a joke. I make such good jokes usually… but this is not one of them. I have heard doctors claim exactly this.)

You would think that after the Healthcare.gov disaster, there would be one person whose job it was to make sure the deployment of EHRs by doctors in the United States was going to work. A person who had no other job responsibilities but to make sure that records were “portable”. Someone who had all of the authority and skills needed to make EHR adoption, including “portability”, a reality.

Currently, there are two “versions” of Meaningful Use. One of them is managed by the Office of the National Coordinator of Health IT (ONC for short) and the other by the Centers for Medicare and Medicaid Services (CMS). For those unfamiliar with these agencies, ONC is regarded as being “in charge” of Health IT matters in the Federal government and CMS is primarily tasked with paying doctors for work under Medicare and other federal insurance programs.

I promise not to annoy you too much with more posts about the Health IT Marketing and PR Conference and associated awards programs and Twitter chats. However, I know that many people who read this blog will be interested in the recently announced HITMC (Healthcare IT Marketing and PR Community) Awards. This is done in conjunction with the HITMC conference and the winners will be recognized at the conference in front of hundreds of your peers. You have until the end of February 2015 to submit your nominations, so submit your own or your colleagues work today.

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